A children’s health policy blog

Governor Walker Misstates Impact of ACA and Its Effect on Medicaid

In a recent Washington Post op-ed, Wisconsin Governor Scott Walker attacked the federal health care reform law, but made one general point I concur with. He recommended looking at the practical impact of the Affordable Care Act in the states, and I wholeheartedly endorse that suggestion.

However, that’s the only point of agreement because the Governor’s assessment of the impact fails to mention any of the scores of ways that the ACA will help Wisconsinites. Walker’s op-ed draws selectively from an actuarial study done for the state by MIT Professor Jonathan Gruber, and the Governor studiously avoids any of the report’s many findings that shed a positive light on the Affordable Care Act (ACA). In addition, the column appears to misrepresent what the ACA would mean for BadgerCare.

The op-ed is similar to a Walker Administration PowerPoint presentation that the state unveiled last year at the same time that it released the actuarial report. An article last August in the Capitol Times reported that Professor Gruber was critical of the negative spin on the study:

“They picked out the most negative aspects of the report to highlight. …Overall I think health care reform is a great thing for Wisconsin.”

Like the state’s other summaries of the actuarial report, the op-ed omits a wide range of positive findings, including the key conclusion that the health care reform law will yield a net reduction of 340,000 uninsured Wisconsinites (a drop of 65 percent). That will save money by promoting preventive care and lowering uncompensated care costs that are shifted to those with insurance.

One of the most perplexing arguments in the op-ed is the statement that “Approximately 122,000 parents, caretakers and pregnant women with an income of more than 133 percent of the federal poverty level will no longer be eligible for Medicaid.” The biggest problem with that assertion is that it suggests that the law will set a cap on BadgerCare eligibility at 133 percent of the federal poverty level (FPL). The ACA does nothing of the sort.

In 2014, after the new exchanges are in place to help low and middle income families purchase subsidized coverage, Wisconsin will have the choice of lowering the ceiling on BadgerCare eligibility of adults to 133% of FPL or maintaining its current eligibility caps (of 200% of FPL for parents and caretakers, and 300% for pregnant women).

In addition, the law gives Wisconsin the legal option, along with generous funding, to expand coverage to 133 percent of FPL for adults who don’t have dependent children. Wisconsin currently provides coverage to some adults in that category, but there is a waiting list of about 134,000. It’s puzzling that the Governor expresses concern that BadgerCare coverage might be cut off for adults over the 133 percent level, yet his remarks to date suggest that he doesn’t support expanding eligibility to the very low income adults below that level.

The ACA offers Wisconsin a wonderful opportunity to strengthen BadgerCare and to integrate it with subsidized coverage through the new exchanges. For that reason and countless others, I’m confident that if Wisconsinites heed the Governor’s advice to look at the law’s practical effects, they will agree that the ACA is a huge step forward for our state and the nation.

The Center for Children & Families (CCF) of the Georgetown University Health Policy Institute is an independent, nonpartisan policy & research center dedicated to expanding & improving health care coverage for America’s children and families.